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Bone mineral density and microarchitecture in patients with essential thrombocythemia and polycythemia vera

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Abstract

Summary

In this cross-sectional study of 45 patients with myeloproliferative neoplasms, we found no evidence of secondary osteoporosis.

Introduction

Patients with essential thrombocythemia (ET) and polycythaemia vera (PV) are at increased risk of fractures but the underlying mechanisms have not been settled. We conducted a study to assess bone mineral density, microarchitecture, estimated bone strength and global bone turnover in 45 patients with ET or PV.

Methods

Patients were evaluated in a cross-sectional study with dual energy X-ray absorptiometry (DXA) at the hip and spine; high-resolution peripheral quantitative computed tomography (HR-pQCT) at the distal radius and distal tibia; and biochemical markers of bone turnover including pro-collagen type 1 N-terminal pro-peptide, osteocalcin, C-terminal cross-linking telopeptide of type 1 collagen and bone-specific alkaline phosphatase. Also, 45 healthy comparisons, matched on age, height and weight with each patient were included as control subjects.

Results

Patients and comparisons had almost identical BMDs: 0.96 (IQR: 0.85–1.07) g/cm2 and 0.96 g/cm2 (IQR: 0.86–1.05 g/cm2), respectively. As well all microarchitecture and estimated bone strength measures were highly similar in the two groups. Levels of bone turnover markers were within reference values in patients.

Conclusion

These results reveal no evidence of secondary osteoporosis among patients with ET or PV. The mechanism behind the increased fracture risk in ET or PV patients remains unknown.

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Acknowledgments

We thank the staff at the Osteoporosis Clinic, Odense University Hospital, for performing the scans. This work has supported by grants from Danish Cancer Society (R90-A6062-14S2) and the Region of Southern Denmark (j.nr. 11/28457).

Author information

Authors and Affiliations

  1. Department of Haematology, Odense University Hospital, Sdr. Boulevard 29, DK-5000, Odense, Denmark

    S. Farmer, H. Vestergaard & H. Frederiksen

  2. Department of Endocrinology, Odense University Hospital, Odense, Denmark

    V. V. Shanbhogue, S. Hansen & A. P. Hermann

  3. Department of Pathology, Odense University Hospital, Odense, Denmark

    C. I. Stahlberg

  4. Department of Clinical Epidemiology, Aarhus University Hospital, Odense, Denmark

    H. Frederiksen

Authors
  1. S. Farmer
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  2. V. V. Shanbhogue
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  3. S. Hansen
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  4. C. I. Stahlberg
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  5. H. Vestergaard
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  6. A. P. Hermann
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  7. H. Frederiksen
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Corresponding author

Correspondence to S. Farmer.

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Ethical approval

All procedures performed in this study were in accordance with the ethical standards of Ethics Committee of Southern Denmark (file no. S-20110110) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards and by the Danish data protecting agency (file no. 2008-58-0035).

Conflicts of interest

None.

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Farmer, S., Shanbhogue, V.V., Hansen, S. et al. Bone mineral density and microarchitecture in patients with essential thrombocythemia and polycythemia vera. Osteoporos Int 28, 677–685 (2017). https://doi.org/10.1007/s00198-016-3788-z

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  • DOI: https://doi.org/10.1007/s00198-016-3788-z

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